Search results for: growing patient

Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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Authors: Ridwan Dewayanto Rusli

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We show how prisoner's dilemma-type competition problems can be mitigated through rapid platform diversification and ecosystem expansion. We analyze a ride-hailing company in Southeast Asia, Gojek, whose network grew to more than 170 million users comprising consumers, partner drivers, merchants, and complementors within a few years and has already achieved higher contribution margins than ride-hailing peers Uber and Lyft. Its ecosystem integrates ride-hailing, food delivery and logistics, merchant solutions, e-commerce, marketplace and advertising, payments, and fintech offerings. The company continues growing its network of complementors and App developers, expanding content and gaining critical mass in consumer data analytics and advertising. We compare the company's growth and diversification trajectory with those of its main international rivals and peers. The company's rapid growth and future potential are analyzed using Cusumano's (2012) Staying Power and Six Principles, Hax and Wilde's (2003) and Hax's (2010) The Delta Model as well as Santos' (2016) home-market advantages frameworks. The recently announced multi-billion-dollar merger with one of Southeast Asia's largest e-commerce majors lends additional support to the above arguments.

Keywords: ride-hailing, prisoner's dilemma, platform and ecosystem strategy, digital applications, diversification, home market advantages, e-commerce

Procedia PDF Downloads 101

Authors: Samina Nazli, Nadia Qamar, Quratulain, Akasha, Saman Jamal

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Objective: The objective is to determine the frequency of iron deficiency anemia among children having febrile seizures. A descriptive Cross-Sectional Study was done in the Pediatric Unit of Allama Iqbal Memorial Teaching Hospital Sialkot from September 2020 to February 2021. Material & Methods: A total of 70 children were studied aged six months to 10 years, with either gender presenting with febrile seizures. All data of the patients was documented, including demographic data like age, gender, residential area, educational status, socioeconomic status and clinical findings at the time of presentation like fever, fits and duration of symptoms etc. Blood hemoglobin and ferritin levels were tested for each patient to evaluate iron deficiency anemia. Results: There were 65.7% male and 34.3% female cases in this study. The age range of the patients was 6 months to 10 years, with a mean age of 4.36 ± 2.71 years. Most of the children (60%) were below three years of age. Most children belonged to low and middle socioeconomic status with a frequency of 42.8% and 45.7%, respectively. Iron deficiency anemia was found in 38.6% of cases. The majority of the mothers were illiterate (65%). There were 44.3% cases from rural areas and 55.7% from urban areas. Conclusion: Iron deficiency anemia is a common problem among children with febrile seizures, younger than 03 years and belonging to rural areas. Illiterate mothers are an important risk factor for iron deficiency anemia in their children.

Keywords: febrile seizure, iron deficiency anemia, illetrate mother, low scioeconomic status, febrile siezure

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Authors: S. Ilahi, S. Almosni, F. Chouchene, M. Perrin, K. Zelazna, N. Yacoubi, R. Kudraweic, P. Rale, L. Lombez, J. F. Guillemoles, O. Durand, C. Cornet

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Great efforts have been dedicated to obtain high quality of GaAsPN. The properties of GaAsPN have played a great part on the development of solar cells devices based in Si substrate. The incorporation of N in GaAsPN that having a band gap around of 1.7 eV is of special interest in view of growing in Si substrate. In fact, post-growth and rapid thermal annealing (RTA) could be an effective way to improve the quality of the layer. Then, the influence of growth conditions and post-growth annealing on optical and thermal parameters is considered. We have used Photothermal deflection spectroscopy PDS to investigate the impact of rapid thermal annealing on thermal and optical properties of GaAsPN. In fact, the principle of the PDS consists to illuminate the sample by a modulated monochromatic light beam. Then, the absorbed energy is converted into heat through the nonradiative recombination process. The generated thermal wave propagates into the sample and surrounding media creating a refractive-index gradient giving rise to the deflection of a laser probe beam skimming the sample surface. The incident light is assumed to be uniform, and only the sample absorbs the light. In conclusion, the results are promising revealing an improvement in absorption coefficient and thermal conductivity.

Keywords: GaAsPN absorber, photothermal defelction technique PDS, photonics on silicon, thermal conductivity

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Authors: Hanen Khaldi

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This paper aims to study the impact of international migration on human security in the Southeastern region of Asia, especially after Asian Financial Crisis 1997-98. International migration has impacts on many dimensions of security: the state security (sovereignty and autonomy); international relationships security (conflicts, terrorism, etc); and immigrants security. The paper aims to improve our comprehension of the impact of international migration on immigrant security in the region of Southeast Asia, particularly “vulnerable workers’’ whose number is growing very fast in the region. The literature review carried out on this matter led us to ask the following two question: 1) Did the creation of ASEAN Community matter on the evolution of immigrants in the region? And How governments try to resolve the gap between economic objectifs and security of immigrants in the region? To answer these two questions, the paper is subdivided in three parts: Firstly, we will show how the creation of the ASEAN Community, especially ASEAN Economic Community, had a significant impact on the pattern of evolution of immigration in this region. Secondly, we will paint a portrait illustrating the vulnerability of immigrants in Southeast Asia, particularly unskilled workers. Finally, using the theories of regional integration, we will assess how governments try to ensure the security and safety of the immigrants. Overall, our analysis illustrate the significant change of the official discourse of the leaders of the ASEAN member states, now more conciliator and especially more open to cooperation, as well as the proliferation of meetings and initiatives between these countries to control mobility flows in the region, and the ensure immigrants security.

Keywords: migrant workers, human security, human rights

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Authors: Li-Ting Chen, Chih-Tao Cheng, I-Ping Huang, Jen-Ho Chang, Nien-Tzu Chang, Fei-Hsiu Hsiao

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Background: Insecurity adult attachment style may be triggered by cancer threat, which in turn influences depression symptoms. Dispositional mindfulness may have benefits of insecure attachment on depression for colorectal patient transfer to survivor. Objective: This study examined the mediating and moderating effects of quality of life (QOL) and dispositional mindfulness on the relationship between insecure attachment style and depression symptoms. Methods: A cross-sectional study design was used. Data were collected using the QOL functional and symptoms (EORTC-C30 and EORTC CR29), dispositional mindfulness (FFMQ), Short form of Experience in Close Relationships Revised Questionnaire (SF-ECRRQ), and depressive symptoms (BDI-II scale). Results: Of the 90 CRC survivors who participated, the indirect effect of both ECR anxiety (β=0.23, CI=0.05-0.44) and ECR avoidance (β=0.12, CI=0.02-0.24) on depression were significantly mediated through EORTC-C29 colorectal symptoms. Three components of dispositional mindfulness (i.e., acting of awareness, non-judging, non-reactivity) as the moderator in the relationship between ECR anxiety and depressive symptoms. Acting of awareness was a moderator in the relationship between ECR avoidance and depressive symptoms. Conclusions: There are two pathways from insecure attachment to depression: through the mediator of colorectal symptoms and the moderator of dispositional mindfulness. Cancer symptom management and mindfulness practices could improve the impact of insecure attachment on depression among CRC patients in a post-treatment transition period.

Keywords: acting of awareness, attachment style, colorectal cancer, disposisitonal mindfulness, depression

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Authors: Ssembatya Joseph Mary

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Introduction: Omphalocele, an abdominal wall defect, occurs in 1 out of 4,000 to 6,000 live births. It is characterized by visceral herniation of small and large intestines, liver, and sometimes spleen and gonads are involved. The viscera is always covered by a three-layered sac. The defect in the mesoderm is mainly due to the failure of lateral abdominal wall folds to unite. About 350,000 ventral hernia repairs are done annually in the united states of America. Surgical repair with a mesh is the gold standard surgical method. With conservative management of Omphalocele, children are eventually closed between the age of 1 and 5 years. Herein, we present a late manifestation of ventral hernia following Omphalocele in a female Ugandan. Case presentation: A 56-year-old female with no known chronic illnesses and normal perinatal history presented with an umbilical swelling since birth with no associated symptoms. She is a married woman to one husband and has five children, and all of them are in good general condition with no such symptoms. She had normal vitals with an umbilical defect measuring about 20cm from the xiphoid process and 10 cm from the symphysis pubis. Surgery was done (component separation) on the second inpatient day, and it was uneventful. The patient was discharged on the 4th postoperative day in good general condition with a dry and clean surgical site. Conclusion: Despite adequate literature about Omphalocele and clear management guidelines, there have been reported cases of adult presentation of ventral hernias secondary to Omphalocele.

Keywords: omphalocele, ventral hernia, uganda, late presentation

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Authors: Man Chung Chu

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In the dynamic family interaction, parental self-efficacy is connected with parent-child attachment. Parental self-efficacy and its corresponding behavior played an influential role in the lifespan development of the child. Recently, Mindful parenting is popularly addressed as it lightens parents’ awareness to their own thoughts feelings and behaviors by adapting a nonjudgmental attitude in the present moment being with the child. The effectiveness of mindful parent is considerably significant in enhancing parent-child relationship as well as family functioning. Parenting in early developmental stage is always challenging and essential for later growth, however, literature is rarely exploring the mediation of mindful parenting on the effect of parent self-efficacy on parent-child attachment in preschoolers’ families. The mediation effect of the research shed light on how mindful parenting should head, where parental self-efficacy training should be incorporated together with mindful family program in attempt to yield the best outcome in the family of young-aged children. Two hundred and eight (208) parents, of two to six years old children, were participated in the study and results supported the significance in the mediator effect of mindful parenting in both facets, i.e. Parent-focused - ‘Mindful Discipline’ and Child-focused – ‘Being in the moment with the child’ where parental self-efficacy is a significant predictor of mindful parenting. The implication of the result suggests that mindful parenting would be a therapeutic framework in promoting family functioning and child’s well-being, it would also be a ‘significant helping hand’ in maintaining continuous secure attachment relationship and growing their mindful children in a family.

Keywords: mediation effect, mindful parenting, parental self efficacy, parent-child attachment, preschoolers

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Authors: Isabella Jabbour

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The world's population is expected to reach over 10 billion by 2050, creating a significant demand for food production, particularly in the agricultural industry. Cellular agriculture presents a solution to this challenge by producing meat that resembles traditionally produced meat, but with significantly less land use. Decellularized plant scaffolds, such as spinach leaves, have been shown to be a suitable edible scaffold for growing animal muscle, enabling cultured cells to grow and organize into three-dimensional structures that mimic the texture and flavor of conventionally produced meat. However, the use of freshwater to remove the intact extracellular material from these plants remains a concern, particularly when considering scaling up the production process. In this study, two protocols were used, 1X SDS and Boom Sauce, to decellularize spinach leaves with both distilled water and ocean water. The decellularization process was confirmed by histology, which showed an absence of cell nuclei, DNA and protein quantification. Results showed that spinach decellularized with ocean water contained 9.9 ± 1.4 ng DNA/mg tissue, which is comparable to the 9.2 ± 1.1 ng DNA/mg tissue obtained with DI water. These findings suggest that decellularized spinach leaves using ocean water hold promise as an eco-friendly and cost-effective scaffold for laboratory-grown meat production, which could ultimately transform the meat industry by providing a sustainable alternative to traditional animal farming practices while reducing freshwater use.

Keywords: cellular agriculture, plant scaffold, decellularization, ocean water usage

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Authors: S. Mohammad Reza Khatibi

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Statistics on urbanization in Iran and around the world show that urbanization rate and urban population had had an increasing growth and, during five decades, this trend shows the fact that growth will still continue for a long time. Therefore, instead of an irregular horizontal city development and growth, a sustainable development is achievable by filling the existing city fabric, organizing the density and changing the use of incompatible old or urban buildings. One approach is the infill development. Infill development is the development of vacant land or wasteland abandoned within built areas or where there already exist facilities and equipment. Simply put, infill development is the use of empty spaces or those lacking intra-city use for city development. Additionally, fulfillment of social justice and creating a safe, secure and desirable atmosphere for citizens to live and stay active along with acquiring equal life opportunities, are among the goals of vision plan of Iran in conflict with which, certain environments have been created by city neighborhoods having physical, social, economic, etc. problems. Accordingly, in order to meet the extensive need of many cities for openness to growing population, this paper aims to investigate the relationship between infill development indicators and life quality in urban neighborhoods, using descriptive-analytical research method. Findings show that infill development indicators in three physical, social and economic categories can be adapted with quality components of urban environments, especially urban neighborhoods, and related guidelines can be offered.

Keywords: infill development, life quality, urban neighborhoods, indicator

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Authors: Angelis P. Barlampas

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PURPOSE: The purpose of this paper is to demonstrate the important role of taking an appropriate and detailed history, in order to reach the best possible diagnostic conclusion. MATERIAL: A patient presented to the emergency department due to the sudden onset of continuous abdominal pain, during the last hour and with the clinical symptoms of an acute abdomen. During the clinical examination, signs of peritoneal irritation and diffuse abdominal tenderness were found. The rest of the clinical and laboratory tests did not reveal anything important. From the reported medical history, nothing of note was found, except for the report of a large liver cyst, for which he was advised not to take any further action, except from regular ultrasound examination . METHOD: A computed tomography examination was performed after per os administration of gastrografin, which revealed a hyperdense ascitic effusion, similar in density to that of gastrografin within the intestinal tract. The presence of a large cyst of the left hepatic lobe was confirmed, contacting and pushing against the stomach. In the area of the contact between the liver cyst and the pylorus, there were extraluminal air bubbles and local opacity of the peritoneal fat, with a small hyperdense effusion. Result : The above, as well as the absence of a history of stomach ulcer or recent trauma, or other pathology, argue in favor of acute pyloric perforation, due to mural necrosis, in response to chronic external pressure from the pre-existing large liver cyst.

Keywords: perforation, stomach, large liver cyst, CT abdomen, acute abdominal pain, intraperitoneal leakage, constrast leakage

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Authors: Mostafa Mohammadpour, Christoph Kapeller, Christy Li, Josef Scharinger, Christoph Guger

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Interictal spikes provide valuable information on electrocorticography (ECoG), which aids in surgical planning for patients who suffer from refractory epilepsy. However, the shape and temporal dynamics of these spikes remain unclear. The purpose of this work was to analyze the shape of interictal spikes and measure their distance to the seizure onset zone (SOZ) to use in epilepsy surgery. Thirteen patients' data from the iEEG portal were retrospectively studied. For analysis, half an hour of ECoG data was used from each patient, with the data being truncated before the onset of a seizure. Spikes were first detected and grouped in a sequence, then clustered into interictal epileptiform discharges (IEDs) and non-IED groups using two-step clustering. The distance of the spikes from IED and non-IED groups to SOZ was quantified and compared using the Wilcoxon rank-sum test. Spikes in the IED group tended to be in SOZ or close to it, while spikes in the non-IED group were in distance of SOZ or non-SOZ area. At the group level, the distribution for sharp wave, positive baseline shift, slow wave, and slow wave to sharp wave ratio was significantly different for IED and non-IED groups. The distance of the IED cluster was 10.00mm and significantly closer to the SOZ than the 17.65mm for non-IEDs. These findings provide insights into the shape and spatiotemporal dynamics of spikes that could influence the network mechanisms underlying refractory epilepsy.

Keywords: spike propagation, spike pattern, clustering, SOZ

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Authors: J. R. Ashrapov, G. A. Alihodzhaeva, D. E. Abdullaev, N. R. Kadirbekov

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Diagnosis of brain tumors is one of the challenges, as several central nervous system diseases run the same symptoms. Modern diagnostic techniques such as CT, MRI helps to significantly improve the surgery in the operating period, after surgery, after allowing time to identify postoperative complications in neurosurgery. Purpose: To study the MRI characteristics and localization of brain tumors in children and to detect the postoperative complications in the postoperative period. Materials and methods: A retrospective study of treatment of 62 children with brain tumors in age from 2 to 5 years was performed. Results of the review: MRI scan of the brain of the 62 patients 52 (83.8%) case revealed a brain tumor. Distribution on MRI of brain tumors found in 15 (24.1%) - glioblastomas, 21 (33.8%) - astrocytomas, 7 (11.2%) - medulloblastomas, 9 (14.5%) - a tumor origin (craniopharyngiomas, chordoma of the skull base). MRI revealed the following characteristic features: an additional sign of the heterogeneous MRI signal of hyper and hypointensive T1 and T2 modes with a different perifocal swelling degree with involvement in the process of brain vessels. The main objectives of postoperative MRI study are the identification of early or late postoperative complications, evaluation of radical surgery, the identification of the extended-growing tumor that (in terms of 3-4 weeks). MRI performed in the following cases: 1. Suspicion of a hematoma (3 days or more) 2. Suspicion continued tumor growth (in terms of 3-4 weeks). Conclusions: Magnetic resonance tomography is a highly informative method of diagnostics of brain tumors in children. MRI also helps to determine the effectiveness and tactics of treatment and the follow up in the postoperative period.

Keywords: brain tumors, children, MRI, treatment

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Authors: Helena Baffoe

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The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance use, empirical evidence, logistic regression

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Authors: Eva Tolmeijer, Emmanuelle Peters, Veena Kumari, Liam Mason

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Cognitive behavioral therapy for psychosis (CBTp) is effective in many but not all patients, making it important to better understand the factors that determine treatment outcomes. To date, no studies have examined whether neuroimaging can make clinically useful predictions about who will respond to CBTp. To this end, we used machine learning methods that make predictions about symptom improvement at the individual patient level. Prior to receiving CBTp, 22 patients with a diagnosis of schizophrenia completed a social-affective processing task during functional MRI. Multivariate pattern analysis assessed whether treatment response could be predicted by brain activation responses to facial affect that was either socially threatening or prosocial. The resulting models did significantly predict symptom improvement, with distinct multivariate signatures predicting psychotic (r=0.54, p=0.01) and affective (r=0.32, p=0.05) symptoms. Psychotic symptom improvement was accurately predicted from relatively focal threat-related activation across hippocampal, occipital, and temporal regions; affective symptom improvement was predicted by a more dispersed profile of responses to prosocial affect. These findings enrich our understanding of the neurobiological underpinning of treatment response. This study provides a foundation that will hopefully lead to greater precision and tailoring of the interventions offered to patients.

Keywords: cognitive behavioral therapy, machine learning, psychosis, schizophrenia

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Authors: Aljabryn Dalal Hamad

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The present explanatory study concerns with the relation between Diabetes Mellitus and Food Balance in the Kingdom of Saudi Arabia during 2005-2010, using published data. Results illustrated that Saudi citizen daily protein consumption (DPC) during 2005-2007 (g/capita/day) is higher than the average global consumption level of protein with 15.27%, daily fat consumption (DFC) with 24.56% and daily energy consumption (DEC) with 16.93% and increases than recommended level by International Nutrition Organizations (INO) with 56% for protein, 60.49% for fat and 27.37% for energy. On the other hand, DPC per capita in Saudi Arabia decreased during the period 2008-2010 from 88.3 to 82.36 gram/ day. Moreover, DFC per capita in Saudi Arabia decreased during the period 2008-2010 from 3247.90 to 3176.43 Cal/capita/ day, and daily energy consumption (DEC) of Saudi citizen increases than world consumption with 16.93%, while increases with 27.37% than INO. Despite this, DPC, DFC and DEC per capita in Saudi Arabia still higher than world mean. On the other side, results illustrated that the number of diabetic patients in Saudi Arabia during the same period (2005-2010). The curve of diabetic patient’s number in Saudi Arabia during 2005-2010 is regular ascending with increasing level ranged between 7.10% in 2005 and 12.44% in 2010. It is essential to devise Saudi National programs to educate the public about the relation of food balances and diabetes so it could be avoided, and provide citizens with healthy dietary balances tables.

Keywords: Diabetes mellitus, food balance, energy, fat, protein, Saudi Arabia

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Authors: Kathleen Cooney, Jennifer Coates, Lesley Leach, Kristin Hrenchir

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The objective of this retrospective study was to determine whether intrarenal injection of pentobarbital sodium is a practicable method of euthanasia in client-owned cats. 131 Cats were anesthetized using a combination of tiletamine, zolazepam, and acepromazine given by of subcutaneous or intramuscular injection. Once an appropriate plane of anesthesia was reached, 6 ml of pentobarbital sodium was injected into either the left or right kidney. The patient’s age, sex, estimated weight, presenting condition, estimated dehydration level, palpable characteristics of the kidney pre and post injection, physical response of the cat, and time to cardiopulmonary arrest were recorded. Analysis of 131 records revealed that cats receiving an intrarenal injection of pentobarbital sodium had an average time to cardiopulmonary arrest of 1 minute. The great majority (79%) experienced cardiopulmonary arrest in less than one minute with the remainder experiencing cardiopulmonary arrest between 1 and 8 minutes of the injection. 95% of cats had no observable reaction to intrarenal injection other than cardiopulmonary arrest. In the 19% of cases where kidney swelling was not palpable upon injection, average time to cardiopulmonary arrest increased from 0.9 to 1.6 min. Conclusions and Clinical Relevance: Intrarenal injections of pentobarbital sodium are similar in effect to intravenous methods of euthanasia. Veterinarians who elect to use intrarenal injections can expect cardiopulmonary arrest to occur quickly in the majority of patients with few agonal reactions. Intrarenal injection of pentobarbital sodium in anesthetized cats has ideally suited for cases of owner observed euthanasia when obtaining intravenous access would difficult or disruptive.

Keywords: euthanasia, injection, intrarenal, pentobarbital sodium

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Authors: Koboro J. Selala

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Whilst the system of collective bargaining is well-researched in South Africa, recent studies reveal that this is an area of law and practice that is poorly understood. Despite the growing attention being paid by most scholars to the role of collective bargaining in the labour relations system, only a handful of the studies have considered collective bargaining as a mechanism of dispute resolution. The purpose of this paper is to provide a critical analysis of the current understanding of the right to engage in collective bargaining in South Africa to assess the extent to which collective bargaining is used to resolve labour disputes. The overall objective is to offer a deeper understanding of the role of collective bargaining in dispute resolution process within the South African constitutional labour law context. To this end, the paper examines the applicable legal framework of collective bargaining to address two fundamental questions that are critical to the proper understanding of the functioning of the South African collective labour dispute resolution system. The first concerns the extent to which the current South African legislative framework supports the fundamental labour rights entrenched in the Constitution of the Republic of South Africa. The second addresses the role of trade unions in collective dispute resolution processes and the extent to which they can best utilize collective bargaining to resolve labour disputes. Finally, the paper discusses the general implications of the findings to stimulate further research and to enhance the constitutional development of collective labour rights in South Africa.

Keywords: collective bargaining, constitution, freedom of association, labour relations act

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Authors: Rebar Mohammed Hussein

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Enhanced Recovery After Surgery (ERAS) protocols have transformed perioperative care, aiming to reduce surgical stress, optimize pain management, and accelerate recovery. This study evaluates the impact of ERAS on anesthesia management in high-risk surgical patients, focusing on opioid-sparing techniques and multimodal analgesia. A retrospective analysis was conducted on patients undergoing major surgeries within an ERAS program, comparing outcomes with a historical cohort receiving standard care. Key metrics included postoperative pain scores, opioid consumption, length of hospital stay, and complication rates. Results indicated that the implementation of ERAS protocols significantly reduced postoperative opioid use by 40% and improved pain management outcomes, with 70% of patients reporting satisfactory pain control on postoperative day one. Additionally, patients in the ERAS group experienced a 30% reduction in length of stay and a 20% decrease in complication rates. These findings underscore the importance of integrating ERAS principles into anesthesia practice, particularly for high-risk patients, to enhance recovery, improve patient satisfaction, and reduce healthcare costs. Future directions include prospective studies to further refine anesthesia techniques within ERAS frameworks and explore their applicability across various surgical specialties.

Keywords: ERAS protocols, high-risk surgical patients, anesthesia management, recovery

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Authors: Maryam Nabati, Mahmood Moosazadeh, Ehsan Soroosh, Hanieh Shiraj, Mahnaneh Gholami, Ali Ghaemian

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Background: Reported effects of obesity on the extent of angiographic coronary artery disease(CAD) have beeninconsistent. The present study aimed to investigate the relationships between the indices of obesity and otheranthropometric markers with the extent of CAD. Methods: This study was conducted on 1008 consecutive patients who underwent coronary angiography. Bodymass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) wereseparately calculated for each patient. Extent, severity, and complexity of CAD were determined by the Gensini andSYNTAX scores. Results: According to the results, there was a significant inverse correlation between the SYNTAX score with BMI(r = − 0.110; P < 0.001), WC (r = − 0.074; P = 0.018), and WHtR (r = − 0.089; P = 0.005). Furthermore, a significant inversecorrelation was observed between the Gensini score with BMI (r = − 0.090; P = 0.004) and WHtR (r = − 0.065; P =0.041). However, the results of multivariate linear regression analysis did not show any association between theSYNTAX and Gensini scores with the indices of obesity and overweight. On the other hand, the patients with anunhealthy WC had a higher prevalence of diabetes mellitus (DM) (P = 0.004) and hypertension (HTN) (P < 0.001) compared to the patients with healthy values. Coexistence of HTN and DM was more prevalent in subjects with anunhealthy WC and WHR compared to that in those with healthy values (P = 0.002 and P = 0.032, respectively). Conclusion: It seems that the anthropometric indices of obesity are not the predictors of the angiographic severityof CAD. However, they are associated with an increased risk of cardiovascular risk factors and higher risk profile.

Keywords: body mass index, BMI, coronary artery disease, waist circumference

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Authors: Lopita Pal, Suresh V. Madha

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Wetlands are areas of marsh, fen, peat land or water, whether natural or artificial, permanent or temporary, with water that is static or flowing, fresh, brackish or salt, including areas of marine water the depth of which at low tide does not exceed six metres. The rapidly expanding human population, large scale changes in land use/land cover, burgeoning development projects and improper use of watersheds all has caused a substantial decline of wetland resources in the world. Major degradations have been impacted from agricultural, industrial and urban developments leading to various types of pollutions and hydrological perturbations. Regular fishing activities and unsustainable grazing of animals are degrading the wetlands in a slow pace. The paper focuses on the spatio-temporal change detection of the area of the water body and the main cause of this depletion. The total area under study (22°19’87’’ N, 88°20’23’’ E) is a wetland region in West Bengal of 213 sq.km. The procedure used is the Normalized Difference Water Index (NDWI) from multi-spectral imagery and Landsat to detect the presence of surface water, and the datasets have been compared of the years 2016, 2006 and 1996. The result shows a sharp decline in the area of water body due to a rapid increase in the agricultural practices and the growing urbanization.

Keywords: spatio-temporal change, NDWI, urbanization, wetland

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Authors: G. Shiha, S. Seif, W. Samir, K. Zalata

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Prospective Validation of the FibroTest Score in assessing Liver Fibrosis in Hepatitis C Infection with Genotype 4 FibroTest (FT) is non-invasive score of liver fibrosis that combines the quantitative results of 5 serum biochemical markers (alpha-2-macroglobulin, haptoglobin, apolipoprotein A1, gamma glutamyl transpeptidase (GGT) and bilirubin) and adjusted with the patient's age and sex in a patented algorithm to generate a measure of fibrosis. FT has been validated in patients with chronic hepatitis C (CHC) (Halfon et al., Gastroenterol. Clin Biol.( 2008), 32 6suppl 1, 22-39). The validation of fibro test ( FT) in genotype IV is not well studied. Our aim was to evaluate the performance of FibroTest in an independent prospective cohort of hepatitis C patients with genotype 4. Subject was 122 patients with CHC. All liver biopsies were scored using METAVIR system. Our fibrosis score(FT) were measured, and the performance of the cut-off score were done using ROC curve. Among patients with advanced fibrosis, the FT was identically matched with the liver biopsy in 18.6%, overestimated the stage of fibrosis in 44.2% and underestimated the stage of fibrosis in 37.7% of cases. Also in patients with no/mild fibrosis, identical matching was detected in 39.2% of cases with overestimation in 48.1% and underestimation in 12.7%. So, the overall results of the test were identical matching, overestimation and underestimation in 32%, 46.7% and 21.3% respectively. Using ROC curve it was found that (FT) at the cut-off point of 0.555 could discriminate early from advanced stages of fibrosis with an area under ROC curve (AUC) of 0.72, sensitivity of 65%, specificity of 69%, PPV of 68%, NPV of 66% and accuracy of 67%. As FibroTest Score overestimates the stage of advanced fibrosis, it should not be considered as a reliable surrogate for liver biopsy in hepatitis C infection with genotype 4.

Keywords: fibrotest, chronic Hepatitis C, genotype 4, liver biopsy

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Authors: Timothy Fwa Yerima

Abstract:

This paper evaluates the development of human rights jurisprudence in Africa by the ECOWAS Court of Justice. It traces that though ECOWAS was not established with the aim of promoting and protecting human rights as the African Court of Human and Peoples’ Rights, no doubt, the 1991 ECOWAS Court Protocol and the 1993 ECOWAS Revised Treaty give the ECOWAS Court its human rights mandate. The paper, however, points out that despite the availability of these two Laws, the ECOWAS Court had difficulty in its human rights mandate, in view of the twin problems of lack of access to the Court by private parties and personal jurisdiction of the Court to entertain cases filed by private parties. The paper considers the 2005 Supplementary Protocol, not only as an effective legal framework in West African Sub-Region that tackles these problems in human rights cases but also a strong foundation upon which the Court has been developing human rights jurisprudence in Africa through the interpretation and application of this Law and other sources of Law of the Court. After a thorough analysis of some principles laid down by the ECOWAS Court so far, the paper observes that human rights jurisprudence in Africa is growing rapidly; depicting that though the ECOWAS Court initially had difficulty in its human rights mandate, today it has a bright and visionary landing. The paper concludes that West African Sub-Region will witness a more effective performance of the ECOWAS Court if some of its challenges are tackled.

Keywords: access, African human rights, ECOWAS court of justice, jurisprudence, personal jurisdiction

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Authors: Azadeh Davachi

Abstract:

Although there is a growing interest in Iranian female migration and gender roles, little attention has been paid to how Iranian migrant women in Australia access and sustain social networks, both locally and spatially dispersed over time. Social network theories have much to offer an analysis of migrant’s social ties and interpersonal relationships. Thus, it is important to note that social media are not only new communication channels in a migration network but also that they actively transform the nature of these networks and thereby facilitate migration for migrants. Drawing on that, this article will focus on Iranian women migrants and the use of social media in migration in Australia. Based on the case of main social networks such as Facebook and Instagram; this paper will investigate that how women migrants use these networks to facilitate the process of migration and integration. In addition, with the use of social networks, they could promote their home business and as a result become more engaged economically in Australian society. This paper will focus on three main Iranian pages in Instagram and Facebook, they will contend that compared to men, women are more active in these social networks. Consequently, as this article will discuss with the use of these social media Iranian migrant women can become more engaged and overcome post migration hardships, thus, gender plays a key role in using social media in migrant communities. Based on these findings from these social media pages, this paper will conclude that social media are transforming migration networks and thereby lowering the threshold for migration. It also will be demonstrated that these networks boost Iranian women’s confidence and lead them to become more visible in Iranian migrant communities comparing to men.

Keywords: integration, gender, migration, women migrants

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Authors: Pooja Verma, Sumana Ghosh

Abstract:

There is a growing need for alternative way of power generation worldwide. The reason can be attributed to limited resources of fossil fuels, environmental pollution, increasing cost of conventional fuels, and lower efficiency of conversion of energy in existing systems. In this context, one of the potential alternatives for power generation is wave energy. However, it is difficult to estimate the amount of electrical energy generation in an irregular sea condition by experiment and or analytical methods. Therefore in this work, a numerical wave tank is developed using the computational fluid dynamics software Open FOAM. In this software a specific utility known as waves2Foam utility is being used to carry out the simulation work. The computational domain is a tank of dimension: 5m*1.5m*1m with a floating object of dimension: 0.5m*0.2m*0.2m. Regular waves are generated at the inlet of the wave tank according to Stokes second order theory. The main objective of the present study is to validate the numerical model against existing experimental data. It shows a good matching with the existing experimental data of floater displacement. Later the model is exploited to estimate energy extraction due to the movement of such a point absorber in real sea conditions. Scale down the wave properties like wave height, wave length, etc. are used as input parameters. Seasonal variations are also considered.

Keywords: OpenFOAM, numerical wave tank, regular waves, floating object, point absorber

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Authors: Farshid Hajati, Federico Girosi, Shima Ghassempour

Abstract:

We present a Deep Belief Network (DBN) method for clustering health trajectories. Deep Belief Network (DBN) is a deep architecture that consists of a stack of Restricted Boltzmann Machines (RBM). In a deep architecture, each layer learns more complex features than the past layers. The proposed method depends on DBN in clustering without using back propagation learning algorithm. The proposed DBN has a better a performance compared to the deep neural network due the initialization of the connecting weights. We use Contrastive Divergence (CD) method for training the RBMs which increases the performance of the network. The performance of the proposed method is evaluated extensively on the Health and Retirement Study (HRS) database. The University of Michigan Health and Retirement Study (HRS) is a nationally representative longitudinal study that has surveyed more than 27,000 elderly and near-elderly Americans since its inception in 1992. Participants are interviewed every two years and they collect data on physical and mental health, insurance coverage, financial status, family support systems, labor market status, and retirement planning. The dataset is publicly available and we use the RAND HRS version L, which is easy to use and cleaned up version of the data. The size of sample data set is 268 and the length of the trajectories is equal to 10. The trajectories do not stop when the patient dies and represent 10 different interviews of live patients. Compared to the state-of-the-art benchmarks, the experimental results show the effectiveness and superiority of the proposed method in clustering health trajectories.

Keywords: health trajectory, clustering, deep learning, DBN

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Authors: Ojin Kwon, Yong-Jin Yoon, Liu Xin, Zhang Hongbao

Abstract:

Wireless Body Area Network (WBAN) is a short-range wireless communication around human body for various applications such as wearable devices, entertainment, military, and especially medical devices. WBAN attracts the attention of continuous health monitoring system including diagnostic procedure, early detection of abnormal conditions, and prevention of emergency situations. Compared to cellular network, WBAN system is more difficult to control inter- and inner-cell interference due to the limited power, limited calculation capability, mobility of patient, and non-cooperation among WBANs. In this paper, we compare the performance of resource allocation scheme based on several Pseudo Orthogonal Codewords (POCs) to mitigate inter-WBAN interference. Previously, the POCs are widely exploited for a protocol sequence and optical orthogonal code. Each POCs have different properties of auto- and cross-correlation and spectral efficiency according to its construction of POCs. To identify different WBANs, several different pseudo orthogonal patterns based on POCs exploits for resource allocation of WBANs. By simulating these pseudo orthogonal resource allocations of WBANs on MATLAB, we obtain the performance of WBANs according to different POCs and can analyze and evaluate the suitability of POCs for the resource allocation in the WBANs system.

Keywords: wireless body area network, body sensor network, resource allocation without feedback, interference mitigation, pseudo orthogonal pattern

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Authors: Charity Ngoatle, Tebogo M. Mothiba, Mahlapahlapana J. Themane

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Misapprehension of medications instructions due to poor health literacy is common in diabetic patients, predominantly leading to suboptimal medication therapy caused by taking less than expected, or getting inadequate medication concentration. Globally, 50% of adults have been reported to have misunderstood medication instructions which could be the cause of not using medication as prescribed. Reading material has been found not to improve people’s knowledge to the extent where they would be informed and knowledgeable about their health. This, therefore, depicts that instructive materials alone cannot improve health literacy but further patient education is still needed to explain what the information really mean. The aim of this study was to investigate patients’ interpretation of prescribed medication instructions at Makanye Clinic in Limpopo Province, South Africa. The study used a mixed method approach. A non-probability purposive and simple random sampling strategies will be used to select ten (10) participants for the pilot study. Semi-structured interviews with a guide and self- administered structured questionnaires will be used to collect data. Tesch’s eight steps for qualitative data analysis and SPSS version 24 with descriptive statistics will be adopted. The preliminary findings from other studies show that: (a) poor health literacy negatively affect medication adherence, (b) general literacy influence health literacy, and (c) there are poor health outcomes and medication adverse effects due to poor medication comprehension.

Keywords: instructions, diabetes mellitus, patients, prescribed medication

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Authors: Akbar Jamali

Abstract:

Hegel is the first great political philosopher who specifically contemplates on bureaucracy. For Hegel bureaucracy is the function of the state. Since state, essentially is a rational organization, its function; namely, bureaucracy must be rational. Since, what is rational is universal; Hegel had to explain how the bureaucracy could be understood as universal. Hegel discusses bureaucracy in his treatment of ‘executive power’. He analyses modern bureaucracy as a form of political organization, its constituent members, and its relation to the social environment. Therefore, the essence of bureaucracy in Hegel’s philosophy is the implementation of law and rules. Hegel argues that unlike the other social classes that are particular because they look for their own private interest, bureaucracy as a class is a ‘universal’ because their orientation is the interest of the state. State for Hegel is essentially rational and universal. It is the actualization of ‘objective Spirit’. Marx criticizes Hegel’s argument on the universality of state and bureaucracy. For Marx state is equal to bureaucracy, it constitutes a social class that based on the interest of bourgeois class that dominates the society and exploits proletarian class. Therefore, the main disagreement between these political philosophers is: whether the state (bureaucracy) is universal or particular. Growing e-government in modern state as an important aspect of development leads us to contemplate on the particularity and universality of e-government. In this article, we will argue that e-government essentially is universal. E-government, in itself, is impartial; therefore, it cannot be particular. The development of e-government eliminates many side effects of the private, personal or particular interest of the individuals who work as bureaucracy. Finally, we will argue that more a state is developed more it is universal. Therefore, development of e-government makes the state a more universal and affects the modern philosophical debate on the particularity or universality of bureaucracy and state.

Keywords: particularity, universality, rational bureaucracy, impartiality

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Authors: Abubakar Samaila

Abstract:

Pastoralism has been an old practice in the Sahel region of west Africa. In recent years, pastoralists in Nigeria have increasingly been migrating on seasonal transhumance southward from the neighboring countries, especially Niger Republic, in search of better grazing conditions due to mainly, climate change. This has increased pressure on farm lands which instigate farmer-herder conflicts. These conflicts occur mainly between farmers and pastoralists but also between pastoralist groups themselves. However, there has been a shift in these conflicts recently to involve traditional institutions and, in some cases, the local authorities along the borderlands. The involvement of local institutions in the conflict has created an incentive to local actors, particularly pastoralcommunity-based groups, in responding to these violent threats. As pastoralists are mobile, these conflicts became difficult to contain and, thus, spill across borders. Consequently, the conflict has now transformed into an urbanized regional conflicts that involve some major cities along the Nigeria-Niger borderlands; Sokoto, Zamfara, and Katsina on the Nigerian side andDosso, Tahoa andMaradi in Niger republic. These areas are now experiencing unprecedented growing wave of violence that have become complex and escalates into a hydra-social conflict. The aim of this research is to investigate how the fluidities of Nigeria-Niger borderland intensified armed conflicts between the local pastoral organizations and sedentary populationspreading to some urban cities along the borderlands. The paper further suggests alternative approaches towards addressing the perennial crisis in African borderlands.

Keywords: pastoralism, climate change, conflict, nigeria, niger, borderlands

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